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NPI Code Detail

MEDICARE: MRS. JENNIFER SUE BEHNKE APN, RN

MEDICARE: MRS. JENNIFER SUE BEHNKE APN, RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPN0000013155TN
2363LP0808XPsychiatric/Mental Health Nurse Practitioner200950051NPOR
3163W00000XRegistered NurseRN0000157343TN
4163W00000XRegistered Nurse200940952RNOR
5363LP0808XPsychiatric/Mental Health Nurse Practitioner13155TN

General Provider Information

NPI Number : 1174708812
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER SUE BEHNKE APN, RN
Provider Business Mailing Address
First Line : 960 NE 28TH ST
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-2210
Country : US
Telephone Number : 503-916-9898
Fax Number :
Provider Business Practice Location Address
First Line : 117 NW 8TH ST
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-5560
Country : US
Telephone Number : 503-379-0208
Fax Number : 503-662-6068
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2007
Last Update Date : 10/16/2020

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